﻿CREATE TABLE [dbo].[CLM_835_Header]
(
[IDKey] [int] NOT NULL IDENTITY(1, 1),
[ClaimSubmitterID] [nvarchar] (38) NULL,
[Financial_BPR01_TransactionHandlingCode] [nvarchar] (2) NULL,
[Financial_BPR02_TotalActualProviderPaymentAmount] [money] NULL,
[Financial_BPR03_CreditOrDebitFlagCode] [nvarchar] (1) NULL,
[Financial_BPR04_PaymentMethodCode] [nvarchar] (3) NULL,
[Financial_BPR05_PaymentFormatCode] [nvarchar] (10) NULL,
[Financial_BPR06_SenderDepositoryFinancialInstitutionDFIQualifier] [nvarchar] (2) NULL,
[Financial_BPR07_SenderDFIIdentifier] [nvarchar] (12) NULL,
[Financial_BPR08_SenderAccountNumberQualifier] [nvarchar] (3) NULL,
[Financial_BPR09_SenderBankAccountNumber] [nvarchar] (35) NULL,
[Financial_BPR10_PayerID] [nvarchar] (10) NULL,
[Financial_BPR11_OriginatingCompanySupplementalCode] [nvarchar] (9) NULL,
[Financial_BPR12_ReceiverDepositoryFinancialInstitutionDFIQualifier] [nvarchar] (2) NULL,
[Financial_BPR13_ReceiverOrProviderBankIDNumber] [nvarchar] (12) NULL,
[Financial_BPR14_ReceiverAccountNumberQualifier] [nvarchar] (3) NULL,
[Financial_BPR15_ReceiverOrProviderAccountNumber] [nvarchar] (35) NULL,
[Financial_BPR16_CheckIssueOrEFTEffectiveDate] [datetime] NULL,
[Reassociation_TRN01_TraceTypeCode] [nvarchar] (2) NULL,
[Reassociation_TRN02_CheckOrEFTTraceNumber] [nvarchar] (30) NULL,
[Reassociation_TRN03_PayerIdentifier] [nvarchar] (10) NULL,
[Reassociation_TRN04_OriginatingCompanySupplementalCode] [nvarchar] (30) NULL,
[ProductionDate_DTM02_ProductionDate] [datetime] NULL,
[Payer_N101_EntityIdentifierCode] [nvarchar] (3) NULL,
[Payer_N102_PayerName] [nvarchar] (60) NULL,
[Payer_N103_PayerIDCodeQualifier] [nvarchar] (2) NULL,
[Payer_N104_PayerIDCode] [nvarchar] (80) NULL,
[Payer_N301_PayerAddressLine1] [nvarchar] (55) NULL,
[Payer_N302_PayerAddressLine2] [nvarchar] (55) NULL,
[Payer_N401_PayerCityName] [nvarchar] (30) NULL,
[Payer_N402_PayerStateCode] [nvarchar] (2) NULL,
[Payer_N403_PayerPostalCode] [nvarchar] (15) NULL,
[Payer_N404_PayerCountryCode] [nvarchar] (3) NULL,
[Payer_REF02_AdditionalPayerID] [nvarchar] (30) NULL,
[Payer_PER01_PayerContactFunctionCode] [nvarchar] (2) NULL,
[Payer_PER02_PayerContactName] [nvarchar] (60) NULL,
[Payer_PER03_PayerCommunicationNumberQualifier1] [nvarchar] (2) NULL,
[Payer_PER04_PayerCommunicationNumber1] [nvarchar] (80) NULL,
[Payer_PER05_PayerCommunicationNumberQualifier2] [nvarchar] (2) NULL,
[Payer_PER06_PayerCommunicationNumber2] [nvarchar] (80) NULL,
[Payer_PER07_PayerCommunicationNumberQualifier3] [nvarchar] (2) NULL,
[Payer_PER08_PayerCommunicationNumber3] [nvarchar] (80) NULL,
[Payee_N101_PayeeEntityIdentifierCode] [nvarchar] (3) NULL,
[Payee_N102_PayeeName] [nvarchar] (60) NULL,
[Payee_N103_PayeeIDCodeQualifier] [nvarchar] (2) NULL,
[Payee_N104_PayeeIDCode] [nvarchar] (80) NULL,
[Payee_N301_PayeeAddressLine1] [nvarchar] (55) NULL,
[Payee_N302_PayeeAddressLine2] [nvarchar] (55) NULL,
[Payee_N401_PayeeCityName] [nvarchar] (30) NULL,
[Payee_N402_PayeeStateCode] [nvarchar] (2) NULL,
[Payee_N403_PayeePostalCode] [nvarchar] (15) NULL,
[Payee_N404_PayeeCountryCode] [nvarchar] (3) NULL,
[Payee_REF02_AdditionalPayeeID] [nvarchar] (30) NULL,
[Patient_PatientIdentifier] [nvarchar] (80) NULL,
[Insured_NM109_SubscriberID] [nvarchar] (80) NULL,
[Corrected_NM109_CorrectedInsuredIDIndicator] [nvarchar] (80) NULL,
[ClaimDate] [nvarchar] (8) NULL,
[ServiceProvider_NM109_RenderingProviderID] [nvarchar] (80) NULL,
[Subscriber_HL01_SubscriberHierarchicalIDNumber] [int] NULL,
[BTSMessageID] [nvarchar] (100) NULL,
[BTSInterchangeID] [nvarchar] (100) NULL
) ON [PRIMARY]


